Michael Day, MD

	I remember when I was first starting out in private practice, in 1979.  I was in the hospital doctor’s lounge one morning when an elderly pediatrician pulled me aside to talk to me. What he had to say to me had nothing to do with a patient, but rather some advice for the future. To summarize, he told me to take a good long look at my young daughter, because I would have very few opportunities as she grew up to be with her and observe her. The practice of medicine would prevent my spending any time with her.

	I was grateful for his poignant advice, realizing what physicians of his generation had gone through to create a successful practice. However, I was determined that his advice would be wrong. I had no plans whatsoever to desert my family and myself to that jealous mistress, medicine. My friendly pediatrician’s advice only steeled me in that resolve. I planned on making sure that I had enough free time to enjoy and nurture my family as well as having time for myself.

, and avoiding professional burnout, has been an issue for physicians for a long time. It is not a new problem, albeit some of the reasons for this have changed over time.

	One would probably have to ask my family how successful I was in creating a proper work-life balance. However, I feel I was reasonably successful, and still enjoy medicine after all these years. Here are a couple of the solutions to overwork and burnout I have come up with over the years.

	One of the things that can lead to overwork is the continual need for us as physicians. There never seems to be enough physicians to go around to take care of our patients’ needs. Throughout my career, I cannot recall ever feeling competition from my colleagues. Medicine is fairly unique in this way. 

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	This situation certainly prevents us from ever going hungry, but it can lead to overwork. If we’re not careful, we can continually expand our hours to take care of more and more patients. We can justify this by the fact that the more we work, the more money we are going to earn. Just as in other fields, we often measure our worth my how much income we bring in.

Next: "Success was being able to do a good quality job in what I did"

	But in medicine, making more money is not always better. The money must be earned, and this involves more time, of which we are more limited. We need to find the right balance.

	As I mentioned, years ago I realized that if I was not careful, this problem could apply to me. One of the ways that I attempted to deal with it was by sitting down at the beginning of every year and budgeting my money and time.

	My wife and I figured out how much money we were going to need to live a comfortable and secure lifestyle. I would figure out the approximate number of hours that I needed to work to accomplish that, how many patients I would need to see and that left time for me to spend relaxing, vacationing or with my family.

	A corollary to not taking enough time off is seeing patients too quickly, trying to work too many into a day’s schedule. This is also not a new problem. One of the common pitfalls that we as physicians make involves trying to see too many patients in a limited time period. 

	This is also partly the result of the demand for physician services and our desire to maximize our profits. But it comes at a price of not being able to give our patients the best of care, and not being able to really learn about and understand our patients and their unique concerns. Rushing through things adds to one’s stress level. It also prevents maximum enjoyment of the practice of medicine. 

	To do the above, one may need to limit patient panel size. We need to realize that we can’t take care of everyone by ourselves. In this way the physician can also manage to see patients back for follow up in a more reasonable period of time, which will improve quality of care. This will also lower our stress levels and increase job satisfaction.

	Improving the efficiency of our labor is another way to help achieve that work-life balance. I have found that working closely and collaboratively with my office staff and with nonphysician providers has allowed me to work much more efficiently and accomplish more in a given period of time.

	My patients seem to enjoy the additional time and attention paid to them, and my co-workers enjoy the additional responsibility and opportunity to help in patient care. It’s a win-win situation. However, the physician must be willing to coordinate, instruct and lead in this process if it is to be successful.

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	What I had to do back in 1979, and continue to need to do, was to redefine what it means to be successful. I didn’t have to be the busiest doctor, see the most patients or make the most money.

	Success was being able to do a good quality job in what I did. It was being able to enjoy, overall, my relationship with my patients and co-workers. It was also allowing myself time for rejuvenation, personal growth and enjoyment of my time outside of my medical practice. 

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